The rotator cuff of the shoulder is made up of four muscles whose tendons come together to form a covering around the head of the humerus (upper arm bone) and top of the shoulder. Together with the joint capsule, ligaments and labrum, the rotator cuff muscles are important dynamic stabilizers and movers of the shoulder joint. As the name implies, the rotator cuff functions to internally and externally rotate the shoulder and lift the arm.
Diagram of the shoulder, including the location of the rotator cuff
Rotator cuff tendonitis (inflammation) and eventual tearing occurs most commonly over a prolonged period of repetitive injury, usually with overhead work-related or athletic activities such as throwing sports or tennis. However, the rotator cuff may be acutely injured in trauma involving a fall on the arm and shoulder or from heavy lifting. (It is common among weightlifters.) Shoulder dislocation may also result in a rotator cuff tear.
Symptoms of rotator cuff tendonitis or tear include pain in the front and/or down the outside of the shoulder, weakness, and stiffness.
Diagnosis of rotator cuff injury is made through careful history and physical exam. This is because there are other conditions which can cause similar symptoms, such as a compressed ("pinched") nerve in the neck, or shoulder arthritis.
Rotator cuff tendonitis may be treated with rest, nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections or platelet-rich plasma (PRP) injections; usually followed by supervised physical therapy to regain shoulder motion and strength. A partial or complete tear of the rotator cuff tendon is generally repaired by arthroscopic surgery. Open surgery (using a larger incision) may be necessary for large, complicated full tears of the rotator cuff.
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